Prognostic relevance of androgen receptor expression in renal cell carcinomas

Abstract

BackgroundDespite rapid discoveries in molecular biology of renal cell carcinoma (RCC) and advances in systemic targeted therapies, development of new diagnostic and therapeutic strategies is urgently needed. The androgen receptor (AR) has been shown to hold prognostic and predicitve value in several malignancies. Here, we studied a possible association between AR expression and prognosis in patients with RCCs.ResultsLow AR expression levels were associated with occurrence of distant metastasis and higher tumor stage in papillary and clear-cell RCCs. Importantly, multivariate Cox regression analyses revealed that AR is an independent prognostic factor for cancer-specific survival.Materials and MethodsThe expression of AR was measured by immunohistochemistry and assessed by digital image analysis using a tissue microarray containing tumor tissue of a large and well-documented series of RCC patients with long-term follow-up information. Chi-squared tests, Kaplan-Meier curves and Cox regression models were used to investigate the possible relationship between AR expression and clinico-pathological characteristics and patient survival.ConclusionsPatients affected by AR-positive tumors exhibit a favorable prognosis by multiple Cox regression, while loss of AR expression is related to aggressive disease. Therefore, assessing AR expression offers valuable prognostic information that could improve treatment selection for metastatic disease. Moreover, our findings highlight a potential therapeutic use of AR pharmaceuticals in patients with RCCs.

Renal cell carcinoma: a systematic review and meta-analysis on expression of androgen receptor

“…Zhu et al, 11 incontestable that AR expression rate was negatively accompanied pT stage and Fuhrman's grade in RCC patients. Also, this relationship was indicated by Foersch et al, 14 and Langner et al 9 , Zhu et al, 11 reported prevalence of AR had a negative relationship with pT stage and grade in RCC patients. Foersch et al, 14 and Langner et al, 9 reported the results opposite of him.…”

“…Also, this relationship was indicated by Foersch et al, 14 and Langner et al 9 , Zhu et al, 11 reported prevalence of AR had a negative relationship with pT stage and grade in RCC patients. Foersch et al, 14 and Langner et al, 9 reported the results opposite of him. Noh et al, 10 said AR expression related with the histological nuclear grade (p<0.027) and TNM stage (p<0.002).…”

“…From nine studies [9][10][11][14][15][16][17][18][19] , two studies 14,17 were Germany, two studies 15,19 were USA and others were from Austria 9 , Korea 10 , China 11 , Italy 16 and Japan 18 . From 1447 patients [9][10][11][14][15][16][17][18][19] , 345 AR expression exist. One hundred seventy-one cases in four studies [9][10][11]18 of meta-analysis study were male, and 59 cases were female (sum=202).…”

“…Mean age (min-max) in two studies was 60.06 . Three studies 9,11,14,18 on pT stage in 132 patients with expression AR showed 51 cases pT stage 1, 20 cases pT stage 2, 41 cases pT stage 3. And also, 160 low grade versus 42 high-grade cases exist in four studies [9][10][11]18 ( Table 1).…”

Androgen receptors: unclear ubiquitious mechanism or the missing key in the triple–negative breast cancer?

“…The presence of AR in malignant melanoma cells supports metastatic potential and affects the development of distant metastases (8). On the other hand, the presence of AR in cells of clear cell or papillary kidney cancer seems to be associated with better clinical course and prognosis of the disease (9).…”